Medco Health Solutions, the largest pharmacy benefits management
company in the United States, last week settled lawsuits brought by state
and federal authorities by agreeing to stop switching patients over to
more expensive drugs not prescribed by their doctors (these drugs were
favored by Medco because of private rebate agreements with drug
manufacturers). Medco also pledged to begin disclosing its rebate
practices to employers, doctors and patients.

http://knowledge.wharton.upenn.edu/index.cfm?fa=viewArticle&id=978

And

The American Heritage Dictionary

rebate: A deduction from an amount to be paid or a return of
part of an amount given in payment.

kickback: A return of a percentage of a sum of money already
received, typically as a result of pressure, coercion, or a secret
agreement.

http://www.bartleby.com/61/

Comment:

A strong case can be made that private rebates not fully
disclosed are, in fact, kickbacks. Some may consider this to be a
nitpicking, semantic argument. But what should alarm us all is that
Medcos Snow trivializes their abusive practices, for which they are being
punished, by suggesting that the patients and employers who were cheated
actually benefited because the kickbacks were really only rebates (with
disclosure issues regarding the nefarious substitution of higher cost
drugs for lower cost drugs).

David Snow should be issuing a public apology for the egregious abuses
of his company. Instead he releases a statement implying that the only
blame lies with others who use the pejorative term, kickback, when Medco
was actually following sound business practices through the rebate
program.

This seemingly trivial dispute has major policy implications. The
Medicare bill prohibits the government from being the direct purchaser of
drugs, but instead requires that middlemen, such as pharmacy benefit
managers like Medco, maintain control of the pharmaceutical benefit. Not
only do they add middlemen administrative costs, but they also expose us
to the compromised ethics of unrepentant executives who believe that
kickbacks awarded for making lucrative drug substitutions are actually
good business practices since, really, theyre only
rebates.

"Our current national health care system is simple: don't
get sick." - Anonymous